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Case Report: Bloodstream Infection with Toxigenic Corynebacterium diphtheriae and Gram-Negative Sepsis in a Child with Burns
ABSTRACT.
Corynebacterium (C.) diphtheriae is the agent for a contagious infection, diphtheria. It may manifest as pharyngitis with pseudomembrane formation and cervical lymphadenopathy, cutaneous infection, or as an asymptomatic carrier. Corynebacterium (C.) diphtheriae is not an invasive organism and it remains in the superficial layers of skin lesions and respiratory mucosa. Systemic complications, such as bacteremia, are rare. We report a case of toxigenic C. diphtheriae detected from blood culture of a 1-year-old male patient with burns, who succumbed to the infection after 8 days of stay in the hospital. Patient did not have specific clinical features suggestive of diphtheria. Initial identification of C. diphtheriae was done based on culture, Albert stain findings, biochemical tests and subsequently toxigenicity testing was done by polymerase chain reaction. Although diphtheria vaccination in infancy is universally recommended since the creation of the Expanded Program on Immunization in the 1970s, there have been reports of toxigenic strains of C. diphtheriae in a considerable number of cases. Rapid and accurate identification of C. diphtheriae infection is crucial to prevent mortality. Continued surveillance for diphtheria is needed to reduce transmission and mortality rates.
Author Notes
Authors’ addresses: Imola Jamir, Priyadarshi Ketan, Symphonia Anguraj, Lulu Jahan, and Apurba Sankar Sastry, Department of Microbiology, JIPMER, Puducherry, India, E-mails: imolajamir3@gmail.com, ketprirule@gmail.com, symphonia640@gmail.com, lulujahanp1792@gmail.com, and drapurbasastry@gmail.com. Narayanan Parameswaran and Rajeswari Rethinaswamy Divakarjose, Department of Paediatrics, JIPMER, Puducherry, India, E-mails: narayanan.p@jipmer.edu.in and dashingdivakar@gmail.com.